10D2216838 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2216838
  • Facility Name: WALGREEN CO
  • Facility Address: 15 S INDIANA AVE
    ENGLEWOOD, FL
    ZIP 34223
  • Facility Phone: 941 473-7787
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDERSON EBAI KAJANG
  • NPI Number: 1528073780
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2216838
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 15 S INDIANA AVE
City ENGLEWOOD
State FL
ZIP 34223
Phone 941 473-7787
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/16/2025
Certificate Expiration Date 3/15/2027
Facility Type Pharmacy
Lab Director ANDERSON EBAI KAJANG

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This page was last updated on: 9/29/2025